Knee pain (knee joint)

Knees are more susceptible to injuries and various diseases than other joints.A significant part of the patients of orthopedists-traumatologists and rheumatologists complain of severe knee pain.From this article you will learn what to do if you suddenly feel severe pain.She is undergoing treatment, the most important thing is to seek medical help with her problems on time. 

What exactly hurts the knee?

The knee joint is the most complex joint, because it carries the main load.Structure: three bones (femur, tibia and patella form one trochlear joint, which consists of two interconnected joints: femorotibial (tibiofemoral) and femoral-patellofemoral (patellofemoral).

The patella is a flat sesamoid (an accessory in the joint) bone that is attached to the head of the femur, slides in its concave groove and acts as a block.Structural features: the front surface of the patella is covered with periosteum, the back surface, which connects to the femur, is covered with hyaline cartilage.The patella is strengthened by ligaments: main and lateral - vertical (upper and lower) and horizontal (lateral - internal and external).

O transmits the strength of the quadriceps femoris muscle to the musculoskeletal formations of the lower leg, ensuring extension of the lower leg at the knee joint.The surface of the bones that form the joint is covered with cartilage, which acts as a shock absorber.Additional shock absorbers that protect the joint from injury are two crescent-shaped cartilaginous menisci located between the femur and the tibia.The joint is held in its proper position by ligaments, tendons and the surrounding capsule.

Injuries and diseases affect different joint tissues.Not everyone can get sick.Therefore, the cartilage tissue does not have nerve endings and therefore can be destroyed imperceptibly and painlessly.But the ligaments and synovial membrane have many nerve endings and in case of injury or inflammatory processes they immediately start to react, which manifests itself in the form of severe pain.With significant destruction of the articular cartilage, pain may be associated with involvement of the periosteum, the outer layer of bone that has good innervation, in the process.

What to do if you have severe knee pain

Intense knee pain can appear suddenly or develop gradually.In any case, it often becomes unbearable.If severe pain occurs, you need to calm down and seek medical help immediately.All this can be treated, specialists will be able to help even with an advanced disease.If you can't see a doctor right now, you can temporarily relieve the pain yourself.

But remember that if you have pain in the knee joint, this is a temporary measure;you still need to seek medical attention;you can't do without it.And it's better not to delay.

How to treat knee and leg pain at home

To alleviate your condition with severe knee joint pain, you can take the following immediate measures:

• Treat the pain with pills.
• Use external pain relievers (ointments, gels).
• Injections.If there is no effect from tablets and external agents, the drug is administered as an intramuscular or subcutaneous injection.

Many medicines can be bought in a pharmacy without a prescription.

With chronic pain in the knee joints, when there is no significant inflammation, you can perform physical exercises that strengthen the muscle-ligament system, improve circulation and metabolism.Systematic training leads to a gradual decrease in pain, despite the fact that the legs are quite crunchy.

An approximate set of exercises for knee pain:

1. Fixed knee.Lie on your back, bend one leg at the knee, raise it and keep it in that position for a minute;the other leg is immobile at this moment;straighten and lower your leg very slowly, rest for 10 seconds and repeat the exercise with the other leg;repeat 10 times;
2. Double leg bend with knees close to face.Lie on your back, bend your legs at the hips and knees, attach the latter close to your face and hold for a minute.Then slowly straighten and lower your legs, rest for 10 seconds and repeat;do 5-6 approaches, gradually increasing the load.

Acute knee pain requires rest;any physical activity and training are contraindicated.

In the case of acute pain in the knee joint, accompanied by swelling and redness of the skin, general condition disorder, elevated temperature, you cannot move the leg, it must be kept at rest.And only after the inflammation begins to subside, you can move first to passive exercises (performed by an assistant), and then to active exercises (performed by the patient himself).

What not to do if you have pain

For chronic pain, the following should not be allowed:

• bruised knee - you can avoid it by arranging your life in such a way as to reduce the risk of injury to a minimum;
• excess body weight is an additional burden on the knees, especially in the elderly;
• heavy physical activity, jumping, strength sports;You should also not run;
• any intoxication, so you have to get rid of bad habits (smoking, alcohol abuse), treat all chronic diseases and foci of infection;
• wearing uncomfortable narrow shoes, shoes with high heels;
• stress, lack of sleep;
• sedentary lifestyle - you have to force yourself to move at certain intervals.

It is also impossible to apply warm compresses without a doctor's prescription: in the case of purulent and hemorrhagic (with intra-articular bleeding) processes, they can cause irreparable damage.

When you need to see a doctor urgently

If you have knee pain, you need immediate medical attention if the following symptoms appear:

• swelling, redness and tenderness in the knee combined with fever and general weakness;
• severe pain in the knee immediately after the injury or some time after it;
• gradual increase in pain intensity;
• occasionally pain appears after physical exertion, prolonged standing, sharp straightening of the leg;
• night pain and associated insomnia;
• if the pain in the knee is very strong, constant, feeling that the inside of the patella hurts.

In any case, knee pain should be a reason to consult a doctor.It makes no sense to treat yourself: it can temporarily reduce or even eliminate pain, but it will not stop the progression of the disease and the destruction of the joint.Treatment should be entrusted to a specialist.

What to do with severe knee pain of various types

Knee pain can vary in nature and duration between people.They can be constantly painful or develop only under certain loads, at night, etc.For example, some pathological processes are characterized by pain in the knee when bending, others - pain in the knee when walking, etc.Only a specialist can understand exactly what hurts and why and how to help the patient.

Pain in the knee due to the corona virus and other viral diseases

Viral infections can cause joint inflammation.As a rule, these diseases develop against the background of an existing infection and pass without any consequences after its termination.Thus, with the flu and other acute respiratory viral infections with an acute temperature, short-term joint and muscle pain and acute arthritis with inflammation and swelling of the knee joints may occur.The exchange rate is favorable to them.

Corona virus infection has its own characteristics: it occurs differently in each patient.Why this happens is not known.During the disease, sometimes painful joint pains, swelling and redness appear - a sign of acute arthritis, but then they disappear.

Arthritis, which begins about a month after infection with the coronavirus, is more dangerous.The fact is that it has a significant impact on the immune system.Disorders of the immune system lead to the development of autoimmune processes.This is especially dangerous for people who have close relatives who suffer from chronic arthritis.Experts note a high risk of developing rheumatoid arthritis (RA) in such patients.The first sign of RA is stiffness in the morning (difficulty bending the knee).

If arthritis occurs after recovery from a viral infection, consult a rheumatologist immediately.

Severe pain below the knee

This may be a sign of the development of a Baker's cyst - an enlarged synovial bursa with fluid located in the popliteal area.The cyst and accompanying pain under the knee arise due to the fact that it is connected to the cavity of the knee joint and is filled with synovial fluid.In this case, the reverse flow of liquid is difficult for various reasons.Most often, the cyst develops against the background of bruises, arthrosis and arthritis of the knee.

A small cyst can go unnoticed for years.But with its considerable size, the surrounding tissues begin to compress, causing pain below the knee, which is exacerbated by physical activity, including walking and running.Women get sick more often.Sometimes the cyst disappears on its own, but often it progresses and increases in volume, which can lead to rupture or suppuration.

If you have pain below the knee, it is better to consult a doctor as soon as possible.Conservative (removal of fluid from the cyst, injection of glucocorticoids) and surgical (removal of the cyst) treatment is carried out.

Severe pain in the left or right knee

Severe pain combined with swelling and redness of the skin above the right or left knee usually indicates the development of an acute inflammatory process.It can be acute nonspecific arthritis (the process can become purulent), reactive arthritis, which begins a few days after a urogenital or intestinal infection.Both diseases present with similar symptoms;an accurate diagnosis can only be made after a complete examination.

The right or left knee can suffer microtrauma, for example, in athletes or workers in certain professions who use one (usually right) knee more.

It is important not to use folk remedies in the early stages, but to carry out the correct treatment, this will allow you to fully recover and forget about the pain forever.But even with an advanced disease, a specialist will always be able to provide help and relieve pain.

Knee and leg pain

Depending on the cause of the disease, its course and the presence of complications, severe knee pain may include:

• in the lower leg below the knee- are rare, this may indicate compression of the nerve branches that innervate the lower leg muscles by inflamed, swollen periarticular tissues in the knee area;pain below the knee in the back indicates compression of the branches of the sciatic nerve, and pain below the knee in the front indicates that the nerves innervating the front surface of the leg are affected;Such diseases are treated by a rheumatologist, but consultation with a neurologist is required;
• above the knee, in the thigh- it is often a sign of a post-traumatic inflammatory process in the femoral-patellar joint;in this case, patellofemoral pain syndrome develops;the pain is strong, aching, sometimes jerking, aggravated by walking;an orthopedist-traumatologist and a rheumatologist will help you deal with pain;
• from the side, from the inside– pain can develop with injury and damage to the internal lateral articular ligament;the pain in the side is strong, jerking, with hemarthrosis (intra-articular bleeding) - shooting, accompanied by joint imbalance, the whole leg creaks when moving;the same pain appears when the external collateral ligament is stretched;help will be provided by an orthopedist-traumatologist.

In order to eliminate the pain, you need to determine its exact cause, and it is impossible to do this on your own.A doctor's help is needed.

Patella pain on back, front and side

Pain in the patella is almost always the result of acute or chronic injuries:

• back pain in knees- causes are associated with damage to the femoral-patellar joint with the development of patellofemoral pain syndrome;the pain is painful, constant, aggravated by walking;
• front- such painful sensations are caused by surface bruises of the knees or frequent prolonged sitting on the knees with microtrauma on the knee;the pain is significant, because the periosteum, rich in nerve endings, is injured;
• lateral knee painin case of rupture or injury of horizontal internal or external patellar ligaments;the injury can develop with frequent long-term microtraumas of the ligaments, for example, during jumping;followed by bleeding into the joint cavity (hemarthrosis);the pain is strong, constant, accompanied by swelling;movements in the leg are difficult.

In order to prevent the development of permanent joint dysfunction at the site of injury, you should immediately seek help from an orthopedic traumatologist.

Pain in the knee that spreads to the leg, heel, groin

It is necessary to understand the causes of radiating acute knee pain.The reason may be:

• entrapment of the femoral nerve;the pain is acute, piercing in nature, starts sharply in the groin area, spreads along the front-inner surface of the thigh and knee, along the nerve branches it can reach the inner edge of the foot and heel;sometimes the patient has the impression that the knee hurts, but it is not so;
• arthritis (gonarthritis) of various origins: swelling of the joint leads to pinching of nerves and the spread of sharp pain in the knees to the groin and down to the heel;in this case, one feels mostly aching pain in the knee, which with sudden movements turns into acute pain with radiation above and below the knee;
• bruise accompanied by hemarthrosis, ligament rupture, severe swelling and nerve compression;
• bruise with fracture or dislocation of the patella and imbalance of the joint;acute pain in the knee extends down the thigh to the groin, along the inner surface of the lower leg - lower, to the heel.

Severe knee pain of this nature requires immediate medical attention.No folk remedies will help, you need to call an ambulance.

Knee pain during extension and flexion

Most often, pain in the knee during bending and extension, as well as when squatting, is a sign of tendonitis - an inflammatory process in the area of the tendinous-ligamentous apparatus of the knee joint.It develops mainly in young men who play sports and is a consequence of frequent repeated microtraumas associated with jumping and constant shaking of the limbs.The first sign is the inability to straighten the knee without pain.

The cause of painful flexion and extension of the knee can also be arthrosis - degenerative-dystrophic changes in the joint with the growth of connective and bone tissue that hinders movement.

Only the treatment of tendinitis or arthrosis helps the patient to get rid of severe pain in the knee when bending and extending.

Severe knee pain at night

Night pain is characteristic of inflammatory processes.It can be latent arthritis, periodically inflamed knee joint due to arthrosis (arthrosis-arthritis).During sleep, joint and periarticular tissues heat up, blood vessels expand, which increases swelling.

The periarticular tissue swells, compresses the nerve endings and causes pain.If at the same time there is pain behind the knee, then this may be a sign of Baker's cyst.How to get rid of swelling and night pain?Treating the underlying disease helps.

Knee pain when walking

Pains when moving, jogging, excruciating pains below the knee are characteristic of degenerative-dystrophic processes in the knee - arthrosis, because during movement the joint surfaces are injured, completely or partially deprived of the shock absorber cartilage.The periosteum, which has good innervation, is affected.Knee pain when going down stairs is also very common.After exercise, patients notice that the pain in the knee continues to hurt for some time.Over time, pain occurs in the foot.

Long-term rehabilitation treatment with the use of chondroprotectors - drugs that restore cartilage tissue will help.In case of complete destruction of the joint - endoprosthetics.

Pain after exercise - squats, running, lifting weights

This indicates a long-term microtrauma of the knee joints and the gradual creation of degenerative-dystrophic processes in them.Sometimes there is pain in one right or left knee.Knuckles crackle.

If there is severe pain in the knee after training, then the athlete needs rehabilitation treatment.Otherwise, there will be a gradual decrease in joint function, accompanied by first periodic and then constant pain.

Knee pain and creaking

Sharp, sudden pain in the knee and creaking (cracking) indicates a rupture of the meniscus - cartilage cushions that absorb shocks in the knee joint.This can be the result of injury or wear and tear on cartilage structures caused by aging.

Severe joint pain may disappear, but knee pain will remain when squatting, then limb dysfunction will gradually increase, followed first by pain during exercise and then constant pain that increases when going down stairs.Over time, the entire limb suffers and creaks, including the foot.Long-term rehabilitation treatment under the supervision of an orthopedist-traumatologist helps.

Knee pain and swelling

Pain accompanied by swelling always indicates the presence of an inflammatory process.It can be aseptic (without the presence of infection, usually after an injury), infectious, infectious-allergic and autoimmune (with an allergy to one's own tissue).

To get rid of such pain, you need to identify their cause and carry out the treatment prescribed by the specialist.

Injuries and diseases that cause knee pain

The most common pathologies accompanied by pain in the knee are:

1. Closed and open knee injuries with intra-articular fractures, dislocations, meniscal tears.All of them lead to the development of inflammatory processes (arthritis), which then turn into degenerative-dystrophic processes (arthrosis) with the creation of constant knee pain and dysfunction.This is the most common cause of knee pain.Athletes are at risk.Even a minor knee injury can cause the destruction of joint tissue cells, which leads to the development of an inflammatory process.In case of significant injuries, all these processes are expressed and accompanied by long-lasting pain.Instability of the knee, which occurs when the ligament apparatus is damaged, is of great importance.Over time, instability increases, nearby tissues are injured, which leads to increased pain in the knee joint, especially when going down stairs.In the absence of appropriate treatment, the process can be complicated by infection, become purulent, threatening the patient's life, or become chronic with gradual progression and destruction of the joint, accompanied by severe pain.
2. Arthritis of the knee joint is an inflammatory process of various origins, accompanied by an increase in body temperature and a disturbance in the patient's general condition.Patients complain that the pain in the knee hurts all the time.The disease can be infectious, infectious-allergic, autoimmune, metabolic in nature.The inflammatory process also takes place differently, depending on the cause that caused it (purulent, rheumatoid, psoriatic, gouty and other arthritis).Sometimes arthritis can be complicated by a Baker's cyst located in the popliteal region.Then there is pain behind the knee.Only adequate treatment prescribed by a traumatologist or rheumatologist will save you from joint destruction and disability.
3. Arthrosis of the knee joint is a degenerative-dystrophic process in the joint that develops after injuries, acute and chronic inflammatory processes and on the background of metabolic disorders associated with aging in the elderly.There is destruction or thinning of the cartilaginous tissue that absorbs shocks (the menisci and the cartilaginous layer that covers the articular surfaces of the bones).The destruction of the joint progresses slowly but steadily.I am concerned about the pain and creaking when moving.In old age, this is the main cause of knee pain.The bones rub against each other, their structure is destroyed, the joint is deformed, all this is accompanied by severe pain.
4. Cysts and tumors.

How to treat severe knee pain

Knee injuries and diseases often lead to the development of patellofemoral pain syndrome (PFPS), pain in the front of the knee joint.Changes in the joint gradually destroy the patellar cartilage, which contributes to the development of joint instability and constant severe pain in the knees.Only rehabilitation treatment prescribed by a qualified specialist can help.

Diagnostics

Knee pain has various causes and requires an individual approach to treatment.First of all, it is necessary to make a correct diagnosis, and this will require an examination in a clinic.And only after that, knee pain treatment is prescribed.

Some diseases cannot be completely cured, but the doctor can remove the pain and stop the destruction of the joint.

In order to determine the causes of pain and diagnose the disease, the following examination is carried out:

• Laboratory tests- clinical, biochemical, immunological blood test, if necessary - sampling and examination of intra-articular fluid (microscopy, culture on nutrient media to determine the sensitivity of the identified infection to antibiotics).
• Instrumental studies: Ultrasound- reveals pathology of soft tissues and the volume of intra-articular fluid radiography- changes in the bone tissue of the knee; CT and MRI- more detailed study of the pathology of soft and hard tissues; diagnostic arthroscopy- appearance and changes in the synovial membrane of the knee.

Methods for treating severe knee pain

Treatment measures are prescribed individually.Pain associated with a knee injury is treated by an orthopedic traumatologist;if the disease becomes chronic, a consultation with a rheumatologist is necessary.If there is a suspicion of a purulent inflammatory process, then the surgeon will better deal with the disease.All chronic inflammatory processes in the joints are treated by a rheumatologist, but specific infectious processes, for example, knee tuberculosis, are treated by a phthisiologist or other specialist in close contact with a rheumatologist.

First of all, they try to eliminate pain as much as possible, using for this purpose both drug therapy (modern drugs for knee pain, including ointments), and non-drug drugs for knee pain (manual therapy, massage, therapeutic exercises, reflexology courses and other traditional methods, folk remedies).In order to reduce the load on the joint and create rest, various methods of immobilization (splints, splints) are used, as well as taping - fixing the joint using special adhesive tapes.

For all acute joint pains, an urgent examination of the patient is carried out with simultaneous anesthesia.All modern and traditional methods of pain therapy are used in the treatment.After that, according to the indications, the patient is hospitalized or outpatient treatment is prescribed, followed by rehabilitation.No patient with pain is left without the attention of a specialist.